Individual
LAURA G. GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1867 AMHERST ST, WINCHESTER, VA 22601-2801
(540) 667-8724
(540) 723-0741
Mailing address
1867 AMHERST ST, WINCHESTER, VA 22601-2801
(540) 667-8724
(540) 723-0741
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
0101231039
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005616662
—
VA
Enumeration date
01/24/2006
Last updated
04/08/2010
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